Why Acromegaly Dies: A Systematic Review

Acromegaly is a rare endocrine clinical syndrome characterized by long-term elevated production of growth hormone (GH) due to a pituitary adenoma tumor. The main problem of acromegaly patients (AC-PTs) is prolonged elevated GH concentration, which leads to increased insulin-like growth factor 1 (IGF-1) production, causing the characteristic tissue and bone overgrowth. The appearance of diabetes in AC-PTs was linked with the high risks of cardiovascular morbidity, indicating that individuals with both conditions face heightened health challenges. Acromegaly typically has a higher cancer incidence rather than the general population. Without early diagnosis and effective treatment, excess GH can have widespread systemic effects, often leading to significant morbidity and mortality due to its multi-systemic effects. Specifically, our study is based on 33 comprehensive analyses of various articles, as evidenced by the references contributing to understanding the association between acromegaly and mortality risks. Multiple factors in acromegaly may decrease the mortality risks, such as the lifelong observation of IGF-1 and GH levels; in contrast, regular screenings for associated conditions like cancer are essential for optimizing patient outcomes. Regular follow-up to evaluate treatment efficacy and manage complications is important for maintaining health and reducing risks linked with acromegaly. This systematic review aims to investigate the factors contributing to increased mortality in AC-PT, with a focus on cardiovascular complications, metabolic disturbances, malignancies, and the impact of delayed diagnosis. The best clinical approach to care for acromegaly should include various specialists in endocrinology, pulmonology, neurology, cardiology, and psychiatry to provide the best management of acromegaly due to the vast range of complications. Early diagnosis, controlling hormonal changes, and treatment of Acromegaly may improve life expectancy in these patients and help reduce mortality rates.